Background/context Hospices are expected to quantify the quality of care and demonstrate outcome improvements^1,2. There has been a change in emphasis from system and process to outcome^1-4. However, little hospice-specific guidance is available^1-6.

The DMH produces quarterly quality monitoring (QM) reports and is seeing useful intelligence.

Aim

• To produce hospice-specific intelligence

• To evidence that the hospice remains low risk.

Approach used QM is part of the hospice’s well-established clinical governance function. Reports use monthly (& rolling annual) data with published statistics (Office of National Statistics; National End of Life Care Intelligence Network).

Electronic patient-notes enable data collation in a way that was impossible with paper notes.

Hospice-specific outcome indicators have been developed to evidence compliance with outcome measures given in the NICE 2011 quality statements² and the essential standards of quality and safety⁴.

Outcomes The hospice has robust evidence of the following:

• Number (%) and diagnosis of patients receiving care

• Primary care aim

• Equity of access

• Impact of the 24/7 advice line

• Percentage of hospice

  • deaths of patients offered an ACP

  • patients achieving their preferred place of care.

• Percentage of in-patients

  • on the LCP at the time of their death.

  • assessed for risks associated with moving and handling.

  • experiencing minor/serious injury.

  • assessed for tissue viability within 6 hours of admission.

• Waterlow score - an indication of patient frailty.

The DMH can demonstrate that twice as many EOL patients receiving care die at home as those not referred to the hospice.